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Healthcare Reform: The Basics

Costs likely to increase, but many will find assistance

Infographic: ACA Impact on Premiums

At least in the short-term, employers and individuals can expect insurance premiums to increase due to the new healthcare reform laws. That’s because health insurers are required to offer more comprehensive coverage to more people, assume greater risk, and take on new fees and assessments related to the regulations. 

“We haven’t seen anything yet that will instantly reduce healthcare costs,” says Rhonda Giles, director of healthcare reform for PacificSource Health Plans. “Health insurers are filing rate increase requests with their state insurance  departments due to enhanced benefits, state and federal taxes and fees, and other factors related to the ACA. While enhancing preventive care benefits and removing dollar limits on essential health benefits are positive changes, it does come at a cost, and that increased cost is directly reflected in premium rates.”

Many Oregonians struggling to pay for individual insurance coverage may be able to receive financial assistance. People without access to group coverage, with incomes up to $45,960 for an individual and up to $94,200 for a family of four in 2013, will be eligible for assistance in the form of federal tax credits and subsidies. That assistance is available on a sliding scale so those with lower incomes receive the most help. What’s more, small employers that offer health insurance may be eligible for the federal Small Business HealthCare Tax Credit to help cover premiums.

Employers are already encountering costs related to the ACA that could further influence their decisions. If you currently pay for dependent coverage,  your premium rates already reflect the increased expense of extending dependent coverage to age 26.

Some of the important questions can only be answered as the new laws take effect, and consumer behaviors begin to provide answers.

Learn More: Introducing Essential Health Benefits (EHBs)

Oregon Information for Large Oregon Employers

Healthcare Reform: The Basics

New Standards for Benefits and Plan Designs

Changes Specific to Group Plans


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Link to PacificSource website HealthcareLawGuide.com